PRE 2010 DOCSSUBJECT
City of Fridley
16 4 45
AT THE TOP OF THE TWINS
B U I L D I N G PERMIT J
i
• _____ COMMUNITY DEVELOPMENT DIV.
r i PROTECTIVE INSPECTION SEC.
i � -
1 I I
CITY HALL FRIDLEY 55432
"�
NUMBER
REV.
DATE
PAGE OF APPROVED BY
612-571-3450
910-F15
10/29/81
JOB ADDRESS 6321 Madison Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
13
6
Christie Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Pat Libert 6321 Madison Street N.E. 571-8758
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Dav-Ko Home Improvement 1325 - 42nd Avenue N.E. 788-5850
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
RSM Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install aluminum siding
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$2/980
$1.49
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$38.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
(� / `-2
$39.99
SIGNATLARE OF dbNTRACfOR 006THORIZEDAGENT (DATE)
WHEN PROPE LY VALIDATED THIS IS YOUR PERMIT
10LJ9a
BLDG INSP DATE
SIGNATURE OF OWNER 0F OWNER BUILDER) IDATEI
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATI94 FOR RESIDENTIAL BUILDING PER14ITS
(New, Alterations, Additions, or Repairs)
OWNER:
,✓ P
ADDRESS:
TEL NO- �®'% / 9 - Z -e
BUILDER: �" 7
ADDRESS:
TEL NO:
Construction Location
• STRMT NO:4� ( STREET: �` 114 zzY
.�
LOT: BLOCK: ADDITION:
P
Corner Lot: Inside Lot:
Setback.:
Sideyards:
Applicant attach to this form two
Certificates
of Survey of lot and
proposed building location drawn
on certificates to scale.
DESCRIPTION OF
CONSTRUCTION
Front:
Depth:
Height:
Square.Feet:
Cubic Feet:
. Front:
Depth:
Height:
Square -Feet:
Cubic Feet:
_
Ld
Type of Construction:
Estimated Cost: $
C_;� -
To Be Cbmpleted:
Alt. A
Alt. B
Proposed Driveway Width If New Opening Is
Desired:
$
$
SEE REVERSE SIDE
OF SHEET .
The undersigned hereby makes application for a permit for the %:,ork' herein specified,
agreeing to do,all work in strict accordance with the City of Fridley ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct,!'
DATE: A _ SIGNATUi2E:
Stipulations:
11W
SUBJECT
of Fridley
6 3
CR
AT THE TOP OF THE TWINS
BUILDING PERM I T
rpCity
COMMUNITY DEVELOPMENT DIV.
SEC.
r PROTECTIVE INSPECTION
HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
10/12/84
JOB ADDRESS 6321 Madison Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
13
6
Christie Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Pat Sibert 6321 Madison Street N.E. 571-8758
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Lloyd's Home Improvement Inc. 1012 - 421� Avenue N.E., Col. Hgts. 788-5602
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Asphalt
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,500
$.75
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$25.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
CHECK FEE
TOTALFEE
cPLAN
"_j
$25.75
IGNATURE OF CONTRACTOR OR AUTHOR) D 'E (DATE)
S IS YOUR PERMIT
WHEN PROPERLY A I TED Tle,
V
SIGNATUREOF OWNERIIF OWNER BUILDER) (DATE)
BLDG )NSP DATE
NEW [ J City of Fridley
ADDN. [ J �R-1 AND R-2
ALTER. [ J Building Permit Application
Construction Address:
Legal Description: j� '
Owner Name & A •ss:
Contractor: e
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Effective 4/1/84
Tel. #
Tel. #/_,�af�
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ J Inside Lot [ ] F . Yd. S tback Side Yard Setback
Type of Construction: Estimated Cost: $
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: �� APPLICANT : Tel. # d t!Z
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ J
SUBJECTIrp4OF
City of Fridley
2822 1
BUILDING
PERMIT
572=�E6®TNETWINS
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
n�
r PROTECTIVE INSPECTION SEC.
®y
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
l 612-571-3450
910-F15
10/13/98
JOB ADDRESS 6321 Madison Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
13
6
1 Christie
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Eileen Zierman
571-8758
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Owner
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Rk REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (24 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
m
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
ISTALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
2056
$1.03
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$74.75
1
FirA SC $2.06
PLAN CHECK FEE
TOT 'FEE
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN RO
VALID THIS S )vOUR PERMIT
�, , N�.Ep ,IF�11IL DE RI I TEI
BL IN$p
BATE
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION p ��
Const ructionAddress:
Legat Description:
Owner Name & Address: c� �Af��--k_ g1 Tel.
Contractor: �,(^�'�(�� ("^ MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EVIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: -� S
Construction Type: Estimated Cost: $ C' os �O
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DAVE: APPLICANT: Tel. #
CITY USE 0
Permit Fee $ ,�� Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ /. 6)J $.50/$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erasion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL L
STIPULATIONS:
/o/a 9 / � 2v0a